Melinda M. Villagran

Cancer Survivorship and Agency Model: Implications for Patient Choice, Decision Making, and Influence

Relative to other types of health communication research (acute care physician-patient communication, communication campaigns, compliance episodes, etc.), investigations of patient communication following the diagnosis of cancer are infrequent. Theoretically driven, empirical research is desperately needed in such postdiagnostic communication processes as survivorship, quality of life, palliative and hospice care, and loss, bereavement, and grief for those millions of people who have been diagnosed with the second leading cause of death in our nation. An organizational model of patient communication is needed that identifies and describes salient issues and processes involved when cancer patients attempt to negotiate the difficult courses of action following the diagnosis of cancer. The cancer survivorship and agency model (CSAM) proposes both general and specific strategies that serve as options for patients seeking to take greater control of the decision-making process related to their treatment and care of cancer. Although seemingly practical in its offering, CSAM is intended to serve as a heuristic springboard for theoretically based, applied communication research focusing exclusively on post diagnostic cancer processes.

Relational progression as a dialectic: Examining turning points in communication among friends

This study claims that relationship development can be viewed as a dialectic. Evidence for this hypothesis is obtained by examining friendships of three different intimacy levels: casual, close, and best friends. Over one-half of the friendships examined exhibited patterns of recalled relational development predicted by viewing development as a dialectic. Five trajectories for friendships were found. The most commonly reported turning points consisted of activities that the friends shared. Few differences were found between casual, close, and best friends; however, number of turning points was negatively related to satisfaction for casual friends. Implications for the conceptualization of relational development and interpersonal communication research are discussed.

A Patient-centered Approach to Breaking Bad News: Communication Guidelines for Health Care Providers

This investigation takes a patient-centered approach to examining strategies physicians use to deliver bad news to patients. Qualitative data were obtained from 68 patients who had received a message they perceived as negative information from a health care provider. Through grounded theory methodology, patient accounts were examined to reveal four provider strategies for breaking bad news. This investigation underscores the importance of using effective communication strategies to achieve patient satisfaction and compliance.

Methodological diversity to reach patients along the margins, in the shadows, and on the cutting edge

OBJECTIVE There is extensive research on novel uses of visual and social media to disseminate health information, but fewer researchers have considered how to use new communication channels to listen to health care consumers and gather data for research purposes. METHODS Current statistics and literature were reviewed to assess potential uses of interactive and visual media for health communication data collection. RESULTS This essay examines the topic of methodological diversity by offering a few examples from current literature and practice on how interactive media can be more fully utilized to engage with research participants, discover appropriate research questions, and collect quantitative and qualitative health communication data. CONCLUSION Social networks, mobile-based technology, photovoice, and microblogging have potential benefits for collecting patient feedback for research, but there are also limitations of using technology-based collection methods. PRACTICAL IMPLICATIONS Researchers should explore advantages and barriers for using interactive technology to access marginalized populations.

Women, Menopause, and (Ms.)Information: Communication About the Climacteric

This research utilizes a communication perspective to examine the dissemination of information about menopause in terms of womens attitudes, beliefs, and knowledge. Specifically, this study uses a grounded theory approach (Glaser & Strauss, 1967) to explore the communicative processes of misinformation concerning womens lived experiences in relation to the climacteric. Five emergent themes extracted from premenopausal, perimenopausal, and postmenopausal womens discourse are identified and described through qualitative data analysis. Findings suggest that due to a lack of consistent communication, women are generally either unknowledgeable or misinformed about menopause and its related issues. Inaccurate information concerning a health-related experience that all women undergo has negative implications for women, their practitioners, and society. Moreover, a clearer understanding of womens experiences concerning menopause may enhance communication in physician-patient interactions (PPIs).

Communication and culture: Predictors of treatment adherence among Mexican immigrant patients:

This study examined communication and culture in clinicians’ interactions with Mexican immigrants in Texas. Specifically, we explore the unique interplay among levels of acculturation, beliefs about culturally-based medical practices, perceptions of medical encounters, and the likelihood of adherence to medical therapy recommendations from US providers. Results suggest that: (a) acculturation predicts perceptions of out-group membership in the patient-provider interaction; (b) beliefs about complementary and alternative medicine are negatively related to medical adherence; (c) quality of care mediates the relationship between physician accommodation and medical adherence; and (d) there exists a complex relationship between out-group perceptions and adherence.

The Milspouse Battle Rhythm: Communicating Resilience Throughout the Deployment Cycle

Military spouses (milspouses) enact resilience through communication before, during, and after military deployments. Based on an organizing framework of resilience processes (Buzzanell, 2010), this study examined milspouses’ communicative construction of resilience during an increasingly rapid military deployment cycle. Narratives from in-depth interviews with military spouses (n = 24) revealed how resilience is achieved through communication seeking to reconcile the often contradictory realities of milspouses who endure physical, psychological, and social difficulties due to prolonged separations from their partners.

Translating Communication Measures for Use in Non-English-Speaking Populations

Research involving comparisons between English-speaking and non-English-speaking populations often includes a process of scale translation. The goals of translation of a psychosocial instrument from its original, source language (e.g., English) to another target language (e.g., Spanish) are to maintain denotative and connotative word meanings, and to ensure the source and target scales correctly measure the attributes of interest. This essay offers advice on some of the important issues related to the translation of instruments used in communication research. Specific concerns about various translation methods are addressed, and suggestions for assessing the semantic equivalence and translation invariance of scales are discussed.

Resident scholarship expectations and experiences: sources of uncertainty as barriers to success.

BACKGROUND Scholarly activity during residency is vital to resident learning and ultimately to patient care. Incorporating that activity into training is, however, a challenge for medical educators. Most research on medical student and resident attitudes toward scholarly activity to date has been quantitative and has focused on level of interest, desire to perform scholarship, and perceived importance of scholarship. OBJECTIVE We explored attitudes, expectations, and barriers regarding participation in scholarly activity among current residents and graduates of a single family medicine residency program. METHODS Using a phenomenologic approach, we systematically analyzed data from one-on-one, semistructured interviews with residents and graduates. Interviews included participant expectations and experiences with scholarly activity in residency. RESULTS The 20 participants (residents, 15 [75%]; residency graduates, 5 [25%]) identified uncertainty in their attitudes toward, and expectations regarding, participation in scholarly activity as an overarching theme, which may present a barrier to participation. Themes included uncertainty regarding their personal identity as a clinician, time to complete scholarly activity, how to establish a mentor-mentee relationship, the social norms of scholarship, what counted toward the scholarship requirements, the protocol for completing projects, and the clinical relevance of scholarship. CONCLUSIONS Uncertainty about scholarly activity expectations can add to learner anxiety and make performing scholarly activity during residency seem like an insurmountable task. Programs should consider implementing a variety of strategies to foster scholarly activity during residency, including clarifying and codifying expectations and facilitating mentoring relationships with faculty.

The impact of communication, attitudes, and acculturation on advance directives decision-making

ABSTRACT This study explores differences in communication about advance directives between European-Americans and Latinos. To highlight potential issues when communicating with patients about advance directives, we identify differences in communication and attitudes, and examine the role of acculturation in decisions about advance directives. Results reveal that Latinos were less likely than European-Americans to communicate about advance directives with providers and family members, and less likely to complete an advance directive.